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Organ transplantation in Arabian Gulf countries: ethical and legal practice and beyond

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Abstract

Almost half a century ago, organ transplantation was introduced to Arabian Gulf countries. The criteria for diagnosing brain death among these countries is relatively similar, in which the main area of discrepancy is the number of physicians required to diagnose and their required specialties. Regarding the organs and tissues allowed for transplantation, they must possess an intrinsic regenerative ability if they are harvested from a living donor to avoid jeopardizing their health. To donate, Arabian Gulf countries follow an opt-in consent system, requiring the donor’s informed consent before organ procurement. Live donors can be related or unrelated to the recipient, although the latter is subjected to variable restrictions among Arabian Gulf countries and prohibition in one of them. This is due to its implication in commercial trade. Furthermore, the Gulf Health Council was established to coordinate different health initiatives and programs between Gulf states, including organ transplantation, in an attempt to improve the health sector of all of its member states. Although organ trafficking is illegal in all Arabian Gulf countries, their penalty systems vary from barring physicians, subjecting them to fines or even imprisonment. As for the attitudes of people towards organ transplantation, the willingness to donate varies among these countries. The rate of organ transplantation remains low. This article aims to cover the history of organ transplantation, brain death diagnosis protocols, organ donation enrollment policies and conditions, as well as the issue of organ trafficking in Arabian Gulf countries.

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References

  1. Bezinover D, Saner F. Organ transplantation in the modern era. BMC Anesthesiol. 2019;19:1–4.

    Article  Google Scholar 

  2. Global Chart. Global Observatory on Donation and Transplant. https://www.transplant-observatory.org/summary/(2019). Accessed 28 Feb 2021.

  3. Key Health Indicators. Ministry of Health. https://www.moh.gov.sa/en/Ministry/Statistics/Indicator/Pages/Indicator-1440.aspx (2019). Accessed 28 Jan 2021.

  4. Saudi Arabia. The Institute for Health Metrics and Evaluation. https://www.healthdata.org/saudi-arabia (2019). Accessed 28 Feb 2021.

  5. Saudi Arabia Summary. Global Observatory on Donation and Transplant. https://www.transplant-observatory.org/summary/ (2019). Accessed 28 Feb 2021.

  6. Al Sayyari AA. The history of renal transplantation in the Arab world: a view from Saudi Arabia. Am J Kidney Dis. 2008;51:1033–46.

    Article  PubMed  Google Scholar 

  7. Data SCOT. Organ transplantation in Saudi Arabia – 2017. Saudi J Kidney Dis Transpl. 2018;29:1523–36.

    Google Scholar 

  8. Shaheen F, Souqiyyeh M, Al-Swailem A. Saudi Center for Organ Transplantation: activities and achievements. Saudi J Kidney Dis Transpl. 1995;6:41–52.

    CAS  PubMed  Google Scholar 

  9. Shaheen F. Organ transplantation in Saudi Arabia. Transplantation. 2016;100:1387–9.

    Article  PubMed  Google Scholar 

  10. Services Provided. Kuwait Transplant Society. https://transplant.org.kw/services-provided/ (2017). Accessed 5 Mar 2021.

  11. Kuwait Decree on law No. 55 of 1987 on Organ Transplantation. Global Observatory on Donation and Transplantation. https://www.transplant-observatory.org/download/decree-on-law-no-55-of-1987-on-organ-transplantation-kuwait/ (2016). Accessed 15 Feb 2021.

  12. About Us. Kuwait Transplant Society, https://transplant.org.kw/en/about-us-2/ (2017). Accessed 15 Mar 2021.

  13. Jamal M. The status of organ transplantation in Kuwait. J Kuwait Med Assoc. 2014;46:194–5.

    Google Scholar 

  14. Kumar S, Sankari B, Miller C, Obaidli A, Suri R. Establishment of solid organ transplantation in the United Arab Emirates. Transplantation. 2020;104:659–63.

    Article  PubMed  Google Scholar 

  15. Kayasseh E. Organ transplantation in the United Arab Emirates: legal, ethical and historical aspects. Electron J Islam Middle Eastern Law. 2014;2:1–23.

    Google Scholar 

  16. Health Authority-Abu Dhabi. Book 4: Transfer and Transplant of Human Organs. https://www.doh.gov.ae/-/media/EE704482B6E444FCA300CABA6578F766.ashx. Accessed 15 Mar 2021.

  17. Purushothaman A, Al Shamsi I, Al Seiari M, et al. Organ procurement from possible donors after brain death: United Arab Emirates (UAE) experience 2017–2019. Transplantation. 2019;103:S20–1.

    Article  Google Scholar 

  18. Ministry of Health and Prevention Issues Decree on Declaration of Death. United Arab Emirates Ministry of Health and Prevention. https://www.mohap.gov.ae/en/MediaCenter/News/Pages/1805.aspx (2017). Accessed 15 Mar 2021.

  19. Maskari M, Al SM. Optimizing solid organ donation in the United Arab Emirates: launching donation after death programs. Transplantation. 2020;104:234–5.

    Article  Google Scholar 

  20. Kumar S, Miller C, Hashimoto K, et al. Establishment of liver transplantation in the United Arab Emirates from deceased and living donors. Transplantation. 2020;104:283.

    Article  Google Scholar 

  21. Mohsin N, Budruddin M, Khalil M, et al. Donor gender balance in a living-related kidney transplantation program in Oman. Transplant Proc. 2007;39:803–6.

    Article  CAS  PubMed  Google Scholar 

  22. Bakr M, Elmowafy A, Abbas M. History of renal transplantation in the Arab World. Arch Hellen Med. 2020;37:208–13.

    Google Scholar 

  23. Mohsin N, Al-Busaidy Q, Al-Marhuby H, Al-Lawati J, Daar A. Deceased donor renal transplantation and the disruptive effect of commercial transplants: the experience of Oman. Indian J Med Ethics. 2014;11:153–6.

    CAS  PubMed  Google Scholar 

  24. Almaslamani Y, Almalki H, Fadhil R, Khalaf H, Asim M. Transplantation in Qatar. Transplantation. 2016;100:2487–8.

    Article  PubMed  Google Scholar 

  25. Law No. 21 of 1997 on the Regulation of Transplantation of Human Organs. Almeezan Qatar Legal Portal. https://www.almeezan.qa/LawPage.aspx?id=181&language=en/ (2020). Accessed 16 Mar 2021.

  26. Khalaf H, Derballa M, Elmasry M, et al. First liver transplant in Qatar: an evolving program facing many challenges. Exp Clin Transplant. 2013;11:423–5.

    Article  PubMed  Google Scholar 

  27. Khder M, AlNoaimi L. Organ donation in Bahrain. Transpl Res Risk Manag. 2019;11:59–68.

    Google Scholar 

  28. El-Agroudy A, Ghareeb S, Alarrayed S, et al. Outcome of kidney transplantation in Bahrain. Abstract# C1919. Transplantation. 2014;98:614.

  29. Death Documentation Form by Brain Function Criteria. Saudi Center for Organ Transplantation. https://www.scot.gov.sa/images/Death_Documentation_Form_by_Brain_Function_Criteria.pdf (2020). Accessed 11 Mar 2021.

  30. Regulations in Oman. Global Observatory on Donation and Transplant. https://www.transplant-observatory.org/download/regulations-in-oman-arabic/ (2020). Accessed 16 Mar 2021.

  31. Law No. (15) of 2015 Regulating the Transfer and Transplantation of Human Organs. Almeezan Qatar Legal Portal. https://www.almeezan.qa/CustomPage.aspx?id=5&language=en (2020). Accessed 16 Mar 2021.

  32. Health Regulation Sector. Government of Dubai, Dubai Health Authority. https://www.dha.gov.ae/Asset%20Library/13032019/brain.pdf (2019). Accessed 16 Mar 2021.

  33. Annual Report for Organ Transplantation in the Kingdom of Saudi Arabia. Saudi Center for Organ Transplantation. https://saudidonation.org/en/home/ (2019). Accessed 17 Mar 2021.

  34. Fageeh W, Raffa H, Jabbad H, Marzouki A. Transplantation of the human uterus. Int J Gynaecol Obstet. 2002;76:245–51.

    Article  CAS  PubMed  Google Scholar 

  35. Center Statistics. Kuwait Transplant Society. https://transplant.org.kw/en/center-statistics/ (2017). Accessed 17 Feb 2021.

  36. Oman Summary. Global Observatory on Donation and Transplant. https://www.transplant-observatory.org/summary/ (2013). Accessed 17 Jan 2021.

  37. Qatar Summary. Global Observatory on Donation and Transplant. https://www.transplant-observatory.org/summary/ (2019). Accessed 17 Feb 2021.

  38. Shepherd L, O’Carroll R, Ferguson E. An international comparison of deceased and living organ donation/transplant rates in opt-in and opt-out systems: a panel study. BMC Med. 2014;12:131.

    Article  PubMed  PubMed Central  Google Scholar 

  39. United Nations Office on Drugs and Crime. Trafficking in Persons for the Purpose of Organ Removal. https://www.unodc.org/documents/human-trafficking/2015/UNODC_Assessment_Toolkit_TIP_for_the_Purpose_of_Organ_Removal.pdf (2015). Accessed 16 Mar 2021.

  40. Saudi Center for Organ Transplantation. Organ Donation Procedures Guide. https://saudidonation.org/en/organ-donation-procedures-guide/ (2014). Accessed 1 Mar 2021.

  41. Kuwait Transplant Society. Kuwait Transplant Law. https://transplant.org.kw/kuwait-transplant-law-2/ (2017). Accessed 1 Mar 2021.

  42. The United Arab Emirates’ Government Portal. Legal provisions on organ donation and transplant. https://u.ae/en/information-and-services/health-and-fitness/organ-donation-and-transplant (2020). Accessed 1 Mar 2021.

  43. Kuwait Transplant Society. State of United Arab Emirates. Law regulating the transfer and transplantation of human organs. https://transplant.org.kw/en/kuwait-transplant-law-2/ (2017). Accessed 1 Mar 2021.

  44. Kuwait Transplant Society. Qatar Law regulating the transfer and transplantation of human organs. https://transplant.org.kw/en/kuwait-transplant-law-2/ (2017). Accessed 1 Mar 2021.

  45. WHO Global Observatory on Donation and Transplantation. Qatar Legislation for Organ Transplantation. https://ont.es/Eastern-mediterranean/Organizational%20and%20legal%20aspects/Qatar%20profile.pdf (2006). Accessed 1 Mar 2021.

  46. Kuwait Transplant Society. Organ Transplants Law in the Kingdom of Bahrain. https://transplant.org.kw/en/kuwait-transplant-law-2/ (2017). Accessed 1 Mar 2021.

  47. WHO Global Observatory on Donation and Transplantation. Oman Legislation for Organ Transplantation. https://ont.es/Eastern-mediterranean/Organizational%20and%20legal%20aspects/Oman%20profile.pdf (2006). Accessed 1 Mar 2021.

  48. Gulf Health Council. Organ Transplantation. https://ghc.sa/en-us/Pages/technicalprogramshealthcareorgantransplantation.aspx (2020). Accessed 4 Mar 2021.

  49. Francis L, Francis J. Stateless crimes, legitimacy, and international criminal law: The case of organ trafficking. Crim Law Philos. 2010;4:283–96.

    Article  Google Scholar 

  50. Human Rights Commission. Anti-Trafficking in Persons Law. https://hrc.gov.sa/en-us/TraffickingInPersons/Pages/Anti-traffickingcrimessystem.aspx (2009). Accessed 16 Mar 2021.

  51. Alrogy W, Jawdat D, Alsemari M, Alharbi A, Alasaad A, Hajeer AH. Organ trade using social networks. Saudi J Kidney Dis Transpl. 2016;27:971–6.

    Article  PubMed  Google Scholar 

  52. Alriyamy NA. Ministry of Information: Sultanate of Oman. Learn about the crimes of human trafficking (part eleven) (removing human organs). https://omaninfo.om/topics/74/show/289950 (2019). Accessed 17 Mar 2021.

  53. Mubarak H. Bahrain Police allegiance & sacrifice: Kingdom of Bahrain Ministry of Interior. Human Trafficking Between Reality and the Law https://www.policemc.gov.bh/mcms-store/pdf/9b963f91-58a8-4e2c-8f96-095ee088c9a7_%D8%A7%D9%84%D8%A7%D8%AA%D8%AC%D8%A7%D8%B1%20%D8%A8%D8%A7%D9%84%D8%A8%D8%B4%D8%B1%20%D8%A8%D9%8A%D9%86%20%D8%A7%D9%84%D9%88%D8%A7%D9%82%D8%B9%20%D9%88%D8%A7%D9%84%D9%82%D8%A7%D9%86%D9%88%D9%86.pdf (2010). Accessed 17 Mar 2021.

  54. Budiani-Saberi D, Delmonico F. Organ trafficking and transplant tourism: a commentary on the global realities. Am J Transplant. 2008;8:925–9.

    Article  CAS  PubMed  Google Scholar 

  55. Mekkodathil A, El-Menyar A, Sathian B, Singh R, Al-Thani H. Knowledge and willingness for organ donation in the Middle Eastern Region: meta-analysis. J Relig Health. 2019;59:1810–23.

    Article  PubMed Central  Google Scholar 

  56. Alghanim S. Knowledge and attitudes toward organ donation: a community-based study comparing rural and urban populations. Saudi J Kidney Dis Transpl. 2010;21:23–30.

    PubMed  Google Scholar 

  57. Al-Shammari S. Public attitude and accessibility concerning kidney donation card and living related donation in Riyadh. Saudi Arabia Ann Saudi Med. 1991;11:336–40.

    Article  CAS  PubMed  Google Scholar 

  58. Soubhanneyaz A. Survey of public attitude, awareness and beliefs of organ donation in Western Region of Saudi Arabia. Am J Intern Med. 2015;3:264.

    Google Scholar 

  59. Almutairi S. Knowledge, attitude, and willingness towards organ donation among medical and health sciences students in Central Region. Saudi Arabia Transpl Res Risk Manag. 2020;12:23–8.

    Google Scholar 

  60. AlShareef S, Smith R. Saudi medical students knowledge, attitudes, and beliefs with regard to organ donation and transplantation. Saudi J Kidney Dis Transpl. 2018;29:1115–27.

    Article  PubMed  Google Scholar 

  61. Jabri G, Sandokji A, Alzughaibi N, Alsehli I. Awareness, beliefs and barriers of organ donation among Saudis in Madinah City, Saudi Arabia. J Health Educ Res Dev. 2016;4:1–5.

    Article  Google Scholar 

  62. Almufleh A, Althebaity R, Alamri A, et al. Organ donation awareness and attitude among Riyadh City Residents. Saudi Arabia J Nat Sci Med. 2018;1:59–63.

    Google Scholar 

  63. Al-Harthi HA, Alzahrany OA. Perceptions and attitudes of Saudi adult population toward organ donation, Taif, Saudi Arabia. Int J Med Sci Public Health. 2015;4:1113–20.

    Article  Google Scholar 

  64. Alhussain B, Alasmari B, Omair A, Altraif I, Altamimi A. Attitudes and perceptions towards organ donation in Riyadh. J Health Specialties. 2018;6:68–71.

    Article  Google Scholar 

  65. Binsaleem S, Agrawal S, Al-Homrani M, Al-Juhayim A, Al-Harbi A. Knowledge and attitude towards organ donation among adult population in Al-Kharj, Saudi Arabia. Saudi J Kidney Dis Transpl. 2017;28:81–9.

    Article  PubMed  Google Scholar 

  66. Sayedalamin Z, Imran M, Almutairi O, Lamfon M, Alnawwar M, Baig M. Awareness and attitudes towards organ donation among medical students at King Abdulaziz University, Jeddah. Saudi Arabia J Pak Med Assoc. 2017;67:534–7.

    PubMed  Google Scholar 

  67. Thirunavukkarasu A, Alanazi M, Albulayhid S, Alinad A, Alqader S, Aljudia H. Knowledge, attitude, and barriers toward organ donation among healthcare science students of Jouf University, Saudi Arabia: a cross-sectional study. Int J Med Dev Ctries. 2020;4:996–1001.

    Google Scholar 

  68. Majeed F. Saudi nursing and medical student’s knowledge and attitude toward organ donation: a comparative cross-sectional study. Int J Health Sci. 2016;10:197–205.

    Google Scholar 

  69. Bosakhar B, Al-Mesailekh Z, Al-Farhan S, Arab D, Al-Tawheid N, Al-Ali N, et al. Predictors of knowledge and attitude regarding organ donation in Kuwait. IMC J Med Sci. 2017;10:1–9.

    Article  Google Scholar 

  70. Al-Mousawi M, Abdul-Razzak M, Samhan M. Attitude of ICU staff in Kuwait regarding organ donation and brain death. Transplant Proc. 2001;33:2634–5.

    Article  CAS  PubMed  Google Scholar 

  71. Janahi F, Al Rais A, Al Rukhaimi M, Khamis A, Hickey D. Public awareness of knowledge, belief, and attitude regarding organ donation and organ transplantation: a national survey from the United Arab Emirates. Transplant Proc. 2018;50:2932–8.

    Article  CAS  PubMed  Google Scholar 

  72. Mohsin N, Militsala E, Budruddin M, Al-Khawaldi H, Al-Dhuhli Y, Al-Rahbi Y, et al. Attitude of the Omani population toward organ transplantation. Transplant Proc. 2010;42:4305–8.

    Article  CAS  PubMed  Google Scholar 

  73. Singh R, Varughese B, El-Menyar A, Agarwal T, Shahbal S, Mekkodathil A, et al. Prevalence of socio-demographic and behavioral factors about organ donation in Qatar: a household survey. Qatar Med J. 2020;2020:5.

    Article  PubMed  PubMed Central  Google Scholar 

  74. El-Shoubaki H, Bener A. Public knowledge and attitudes toward organ donation and transplantation: a cross-cultural Study. Transplant Proc. 2005;37:1993–7.

    Article  CAS  PubMed  Google Scholar 

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AlSulaiman, N.S., Alassaf, M.A., Boumarah, D.N. et al. Organ transplantation in Arabian Gulf countries: ethical and legal practice and beyond. Forensic Sci Med Pathol 17, 670–678 (2021). https://doi.org/10.1007/s12024-021-00398-6

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